To be filled in by the consignee dealer of Haryana before sending to the consignor

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1 VAT D3 CHALLAN INWARD [See Rule 56(1), (4) and (5)] To be sued by a dealer registered under the Haryana Value Added Tax Act, 2003 for import of goods in the State of Haryana COUNTER FOIL (To be retained by the user for record) To be filled in by the consignee dealer of Haryana before sending to the consignor 1. Name & address (incl. Dist. & state) of consignor TIN No. If any 2. Nature of transaction Purchase Other 3. of the consignee 4. Stamp of TIN No., Name and Address of the 5. Date To be filled in by the consignee after receipt of Goods 1. Name of Commodity 2. Quantity of Goods (No. of Packets) 3. Weight (in Quintals) 4. Value of goods (a) In figures (ignore paise) 5. No. and date of cash memo/bill / / Tax Invoice no. 6. Registration No. of goods carriage 7. Date of receipt of goods 8. of the consignee 9. Stamp of TIN No., Name and address of the 10. Date VAT D3 CHALLAN INWARD [See Rule 56(1), (4) and (5)] To be sued by a dealer registered under the Haryana Value Added Tax Act, 2003 for import of goods in the State of Haryana COUNTER FOIL (To be retained by the user for record) To be filled in by the consignee dealer of Haryana before sending to the consignor

2 1. Name & address (incl. Dist. & state) of consignor TIN No. If any 2. Nature of transaction Purchase Other 3. of the consignee 4. Stamp of TIN No., Name and Address of the 5. Date To be filled in by the consignee after receipt of Goods 1. Name of Commodity 2. Quantity of Goods (No. of Packets) 3. Weight (in Quintals) 4. Value of goods (a) In figures (ignore paise) 5. No. and date of cash memo/bill / / Tax Invoice no. 6. of the consignee 7. Stamp of TIN No., Name and address of the Date 1. Registration No. of goods carriage 2. Date of journey 3. Stamp of Name and address of the 4. of FORM VAT D3 [See Rule 56(1)(4) and (5)] ORIGINAL (To accompany the goods in transit) 1. Name of commodity 2. Quantity of goods (No. of packets)

3 3. Weight of goods (In Qtl.) 4. Value of goods (Rs. Only) (a) in figure 5. (a) No. of cash memo / bill no sale/ (b) Date 6. (a) Name and address of the consignee (b) TIN if any Sale Other 8. Stamp of TIN No., Name and address of the 9. Date of Filling of challan 1. Registration No. of goods carriage 2. Date of time of dispatch DD MM YY HH - MM 3. Stamp of Name and address of the 4. of Punch month of Use FORM VAT D3 [See rule 56(1) (4) and (5)] COUNTER FOIL (For record of consignor) 1. Name of commodity 2. Quantity of goods (No. of packets) 3. Weight of goods (In Qtl.) 4. Value of goods (Rs. Only) (a) in figure 5. (c) No. of cash memo / bill no sale/ (d) Date

4 6. (c) Name and address of the consignee (d) TIN if any Sale Other 8. Stamp of TIN No., Name and address of the 9. Date of Filling of challan FORM VAT D3 [See Rule 56(1)(4) and (5)] DUPLICATE (To be handed over to the assessing authority) 1. Name of commodity 2. Quantity of goods (No. of packets) 3. Weight of goods (In Qtl.) 4. Value of goods (Rs. Only) (a) in figure 5. (e) No. of cash memo / bill no sale/ (f) Date 6. (e) Name and address of the consignee (f) TIN if any Sale Other 8. Stamp of TIN No., Name and address of the 9. Date of Filling of challan 1. Registration No. of goods carriage 2. Date of time of dispatch DD MM YY HH - MM 3. of

5 4. Stamp of Name and address of the

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